SHOCK! Three Simulated Case Series for Medical Students

Publication ID

Published

Version

9711

February 13, 2014

1

Description

This case series is a set of three High Fidelity Simulation Cases designed to be given in a block (approximately three hours in total duration), to Clerkship students (3rd or 4th year medical students), during their rotation in the Emergency Department. The cases are independent, but build on each other to give the learner a comprehensive understanding of different shock, and management of shock, in the Emergency Department setting. It is recommended to give the three cases back, to back, to back, in a set block of time for maximal effect and learning.

Academic Focus

Intended Audience

Authors & Co-Authors

Primary Author

Paul Ko, MD, FACEP
State University of New York Upstate Medical University

Co-Authors

Matthew Sarsfield
State University of New York Upstate Medical University

Rodney Freeman
State University of New York Upstate Medical University

Jennifer Campoli
State University of New York Upstate Medical University

Kara Welch
State University of New York Upstate Medical University

Outcomes

Effectiveness and Significance

This simulated case series was developed over three years ago and has been used extensively for the last three years on over 360 students, during the Emergency Medicine Clerkship. This is the first simulated case series on shock that we can find in MedEdPORTAL. There are individual cases on topic such as sepsis, but not a comprehensive set of simulated cases on shock. We believe these three cases highlight key and important types of shock that are typically seen or that a student need to know how to manage. The simulation case series has been extremely well received by students (see feedback attached), and the cases have been refined to its current form through three years of implementation.

Special Implementation Guidelines or Requirements

The submitted simulation case series is a set of three High Fidelity Simulation Cases designed to be given in a block (approximately 2.5-3 hours in total duration) to Clerkship students (3rd or 4th year medical students) during their rotation in the Emergency Department. The cases are independent, but build on each other to give the learner a comprehensive understanding of different shock and management of shock in the Emergency Department setting. It is recommended to give the three cases back, to back, to back, in a set block of time for maximal effect and learning.

Lessons Learned

We have been teaching these three cases as a series and devote half a day of student clerkship to this activity starting August 2011 (120 students per year over last 3 academic years). We limit the groups to a maximum of three to five students with an instructor for optimal learning conditions. In each case, we divide up the tasks, and have one student obtain the history, one student do the physical exam, one student be the ‘historian’ (write the history, physical exam, differential diagnosis, and workup on a whiteboard), and one student be the ‘team leader’ who is in charge of the overall case scenario.

The scenarios are quite easy to program, and generally only require the operator to input initial vital signs, someone to give the patient’s history, and adjustment in vital signs depending on student’s treatments (worsening or improving).

Last year, we implemented the use of the Simulation Assessment Form (see attached) for faculty who are observing the students to document student performance on each case, and whether they met required expectations based on the critical actions for each case (see each individual case for details). We encourage the group of three to five students to work in teams, but in the assessment denote each student’s specific role in the simulation and comments on their performance by the observing faculty.

Additional area of emphasis in the last year has been the communication component, specifically speaking with consultants. We have incorporated near the conclusion of each case where the lead student is asked to speak to either the ICU physician, consultant (Gastroenterologist in case 2) to summarize the case succinctly, as well as learn the specific skills of speaking to a consultant. They are given feedback and assessed on this component.

Copyright

This information is made available under the Creative Commons license.
More details

Comments

No comments available.

Join the Conversation

Share your thoughts with other users. Please sign in to comment on this material.